Fight over Obamacare is anything but over in Florida

Florida isn't just a battleground state for presidential elections; it's ground zero in the nation's Obamacare wars.

It's all about demographics. And geographics.

Retiree-heavy Florida has a surplus of voting seniors nervous about Obamacare's changes. But Hispanics -- the state's least-insured but fastest-growing population -- tend to support the Affordable Care Act.

The fourth-most populous in the nation, Florida is the most-diverse political swing state and has the nation's second-highest rate of the uninsured, nearly 25 percent.

Active Democratic voters, who outnumber Republicans by more than 500,000, learned last year from President Obama's campaign that the law can be a political plus -- especially among Hispanics -- after it was a millstone in 2010.

Republicans control the state power structure, and have fought Obamacare in court, with new laws, at the ballot box and on TV.

Two of the most-recognizable Republican figures in the fight against the act: Florida Sen. Marco Rubio and Gov. Rick Scott, who's up for reelection next year and launched his political career four years ago by founding a group opposed to Obamacare.

So 2014 could become a political tie breaker over the Affordable Care Act, which has remained unpopular overall in Florida since its passage.

"Florida is ground zero for Obamacare," said John Anzalone, President Obama's Florida pollster. "If you take a look at all of Florida's natural constituencies, you have seniors ... You have minority communities, including Hispanics."

"And you have areas of the state, like Fort Myers, that

were heavily impacted by the recession," he said. "Also, Miami-Dade is a heckuva lot different than the Tampa area. And then you have North Florida, which is really Southern."

The travel schedule of the Obama Administration's top health official, Kathleen Sebelius, attests to Florida's importance.

Sebelius has been to Florida five times since June -- more than any other large state, in large part because the state refuses to help set up health-insurance marketplaces. So the federal government has to do it. Sebelius has also repeatedly visited GOP-led Texas, which has the nation's highest uninsured rate at 25 percent, also has refused to go along with Obamacare.

Called insurance "exchanges," the online marketplaces -- including Spanish-language ones Sebelius touted Tuesday in Miami -- are designed to help provide policies to individuals who are now mandated to buy coverage or pay a penalty tax.

The exchanges go online Oct. 1. Sept. 30, is another deadline: The end of the federal government's budget year. Gridlocked Congress hasn't passed a new budget, requiring a temporary one, called a continuing resolution, to be passed.

But Rubio, joining Texas Sen. Ted Cruz and Utah Sen. Mike Lee, has helped pressure House Republicans to refuse to support a resolution that doesn't temporarily defund Obamacare. On Friday, the House voted largely along party lines to defund it -- the 42nd anti-Obamacare vote in the chamber. Democrats and White House officials say they won't budge, increasing the likelihood of a government shut-down and possible credit downgrade.

Top Republicans had indicated they have little appetite for a shutdown and would be willing to the pass the bill without the health care provision. But it is unclear how much clout the leadership has over tea party-backed lawmakers still insisting the shutdown is worth the risk.

The tactic is dividing Capitol Hill Republicans, and the results of a shutdown are being described as a "disaster" that could hurt the economy or the GOP's standing in public-opinion surveys.

"The real disaster is Obamacare itself," Rubio said in a Senate floor speech in July when he doubted whether some of the state exchanges would be up and running.

Rubio pointed out that Obama postponed a mandate that employers offer health insurance: "It is such a disaster that the people who supported it are now delaying implementing portions of it."

During the August recess, Rubio toured parts of North and Central Florida to highlight what he said were the failures of Obamacare as seen through the eyes of regular Florida citizens and businesses, like the iconic Gatorland and SeaWorld theme parks in the Orlando area.

There, Rubio said, park owners are like other businesses big and small that are struggling over how to balance higher insurance costs, with the need to keep people employed and customer prices low.

Sebelius rebutted some of the criticism in singling out reports about SeaWorld scaling back part-time employees. She said SeaWorld is adding more full-time employees and said that "they will have affordable health coverage for the first time ever in the new markets."

She bashed the Florida Legislature for passing a law last year that, for two years, removes the state's insurance office from reviewing the cost of health insurance plans offered through the exchanges.

The law could allow insurers to raise rates with little oversight, which could put "Florida consumers at great risk," Sebelius said. Republicans say the statute is designed to remove conflicts between state and federal health insurance law. The law, which Sebelius said was unique to Florida, was just one example of efforts in Tallahassee to slow, disrupt or question Obamacare by:

Suing to block Obamacare as unconstitutional. Joined by peers in other conservative-run states, Florida Attorney General Pam Bondi lost that battle in the U.S. Supreme Court.

Rejecting $9 billion in extra federal Obamacare money over three years to expand Medicaid, the federal-state health insurance program for the poor. Scott called for the expansion of Medicaid last year, but he spent no political capital to try to persuade a recalcitrant Florida House to back him.

Proposing a state constitutional amendment in 2012 designed to block Obamacare-like government requirements that people buy health insurance. It failed, with 48.5 percent supporting it and 51.5 opposing.

Refusing to set up the state exchanges, even returning federal incentive grant money designed to do it.

Heavily regulating Obamacare "navigators," health coordinators who would help people figure out the complicated. The Department of Health, a Scott agency, earlier this month ordered 60 county health departments to deny navigators the ability to tout the new health-insurance law on premises.

"My biggest concern is about privacy. They're getting a lot of our citizens' information and haven't told us how they're going to use it, how they're going to share it," Scott told reporters last week.

Never miss a local story.

Sign up today for unlimited digital access to our website, apps, the digital newspaper and more.